Can we put families back in the frame?

A guest post by Irene de Haan,lecturer in social work in the Faculty of Education and Social Work at the University of Auckland and a registered social worker. Irene’s previous roles include Senior Advisor at the Office of the Chief Social Worker and Principal Community Engagement Advisor at the Families Commission. Currently Irene is involved in reviews undertaken for the Family Violence Death Review Committee. Her research focuses on the promotion of child and family well-being and the prevention of maltreatment and family violence.

Tony Stanley ‘s post in August observes slippage in UK social work, from helping to surveillance. In New Zealand, social workers interested in child and family well-being have another kind of slippage to worry about – from a partnership model of family support, focussed on families’ self-defined needs, to an instructive model of parent education focused on the development and behaviour of individual children considered ‘at risk’.

The Children, Young Persons and their Families Act 1989 was internationally acclaimed for encouraging family-led decision-making and supporting kinship relationships. The Act recognised that what children need is security within their own families – and that families need support while raising children. Good support reduces the need for placement in care, an experience that commonly disrupts children’s attachments and weakens their sense of belonging and identity (Zeanah, Shauffer & Dozier, 2011; Burgess, Rossvoll, Wallace & Daniel, 2011). So, the Act promoted accessible, community-based services. Organisations across New Zealand received government funding to provide supportive social work that would help families access resources, resolve problems and meet the needs of adults and children alike. Despite convincing arguments in favour of a partnership approach to working with families (Arney & Scott, 2013) more recent funding does not reflect this focus. With the notable exception of Whanau Ora, holistic services are now few and far between. Why is this so? Are we reverting to ideas about ‘child rescue’ that have been shown to be inadequate (Humphreys & Absler, 2011; Scott & O’Neil, 1996)? Has hopelessness prevailed about the scale and complexity of problems commonly confronting families today?

Hope is the hallmark of the family support model (Scott & O’Neill, 1996).

From this perspective, a partnership approach to working with families is the best way to promote the well-being of all children, all of whom are vulnerable in some ways. The model uses strengths-based techniques and is responsive to families’ unique situations and to local circumstances. A fundamental feature is easy access, a ‘low threshold’ that enables families to seek and receive support for relatively common problems while developing enough trust to disclose something they think shameful or likely to evoke intervention by authorities. The key to success is respectful relationships. Workers get to know families and their stories and so can offer genuinely useful assistance, whether emotional support, access to resources, information, practical strategies or guidance. Empathy encourages people to reveal the harsher realities of their lives. Family support work combines capacity to confront gruelling truths with optimism about reversing a downward spiral of adversity and averting worse problems.

New Zealand family support services were not systematically evaluated. It is thus hard to argue that they prevented harm and promoted well-being – outcomes notoriously tricky to measure – but anecdotal evidence suggests that many did much good, especially when embedded in a community and staffed by people willing to learn how to respond to issues troubling people in that community. Some family support services still survive, probably because they are now so useful to their communities that withdrawing funding would cause outrage. Mostly, however, holistic family support has been superseded by parent education programmes, typically requiring professional referral of families deemed ‘high risk’.

Now, many families get too little help, too late. Even when problems are chronic, violence is normalised or there is serious threat to people’s lives, help is hard to find (Family Violence Death Review Committee, 2014; Wilson, Smith, Tolmie & de Haan, 2015). This is sometimes the case when families labelled ‘high risk’ are on the caseloads of the plethora of professionals and agencies that constitute ‘the system’. Equally worrying, deprivation blights the lives of many families. The scale of unmet need is clear from frequent media stories featuring hungry children or housing conditions that compromise well-being, health and indeed life. How much better it would be to provide meaningful, preventive support than to ignore problems that cause increasing distress and trauma. Social workers understand the challenges of raising children in a complex world where problems – financial hardship, insecure housing, unstable employment, addiction, unremitting stress, partner violence – commonly co-occur, multiply, intensify and perpetuate harm. Family support social work offers ways to interrupt this pattern.

If hopelessness has indeed prevailed, then social workers must protest. The social work role is about holding hope. It involves comprehending both the big picture and people’s personal stories, gaining understanding of how each affects the other and using this knowledge to advocate for change. Social work is grounded in human rights. At the recent European Domestic Violence Conference in Belfast, Joanna Goodey, of the European Union Agency for Fundamental Rights, declared that rights demand responses – the state has a duty, statutory and moral, to act. Families and their individual members have rights, as recognised and defended by New Zealand legislation. The problem facing us, hopefully reactivated by controversy and debate around the idea of offering support to families with difficult circumstances flagged by predictive risk modelling, is how best, collectively, we can promote people’s rights by responding to hidden suffering or even preventing suffering occurring in the first place.

4 thoughts on “Can we put families back in the frame?”

An excellent piece Irene. What your blog highlights is that as services become more targetted (via a range of means) and focussed exclusively on ‘high risk’ populations, the higher the threshold for services becomes, and who controls access to them is channeled into professional hands. The gap between universal and targetted services increases, and entry to them depends exclusively on an expert referral of some kind. Instead, we need more ‘hooded’ services (those offered as a discreet extension of universal services) that people can choose to access if needed, that have no stigma attached to them. This is the missing link’ between universal and secondary targetted services.

While there is a place for parent education programmes for some families, holistic services are certainly needed as well: the fit between the family and service is key. As Fuller & Nieto (2014) recently concluded: ” A review of parent training programs currently in use in most child welfare agencies concludes that the search for effective parent training programmmes for child welfare families has been long and slow…they lack good fit with the general CWS population because … most parent training programs have been developed to teach parents alternatives to excessive discipline, when the vast majority of parents who receive these services have been referred for reasons other than physical abuse…” (:53).
Fuller, T. & Nieto, M. (2014) Child welfare services and risk of child maltreatment rereports: do services ameliorate initial risk? Children and Youth Services Review, 47: 46 – 54.

Thanks for your thoughtful comment. For some time I’ve been very concerned that there is a lack of understanding of the importance of comprehensive secondary prevention services that can respond to what really troubles families i.e. not necessarily child development or behaviour, although I agree there is certainly a place for that kind of service. Often of course families desperately need support for problems other than child development and behaviour – I was very troubled by the lack of help offered to the Auckland family who were living in a damp house and last year lost their child (Emma-lita Bourne, who died after suffering pneumonia).

I agree with your point about access to services, that as services become more targetted, professionals become gatekeepers. And then we have the additional issue of the capacity of those professionals to recognise distress. My death review work strongly indicates that even child-focused home visiting services are often unaware of what’s actually going on in a family’s life – either they don’t ask or the real problems are concealed, probably because of a lack of trust. I’m not sure whether hooded service provision is the same as cascading service provision but either way I do think that some professionals (midwives, well child nurses, teachers) are in a good position to refer to a family support service if only one is available – but will they pick up on underlying problems if they are not told?

The family support agency I used to work for (Homebuilders Family Services in Warkworth – am now on the Board there) is available to any family (with children) ‘under stress’. This dispels stigma – also the workers take a down to earth, matter of fact view of help seeking, framing this as sensible and strong. Many families self refer but professionals also refer to the agency (a huge range of people do in fact). However, the process is for the family to be asked if they would like to talk with a Homebuilders worker before they are referred – and most do, because of the agency’s great reputation. Typically, after some time (but not usually very long) the Homebuilders worker is told about additoinal underlying issues like past sexual abuse, debt, gambling addictions, drug abuse etc etc – I have an idea you have a family support background yourself and you’ll know the stories. What I’d like to see is greater availability of similar services – as well as preventing harm and trauma they would actually save money for the government!

I agree that this blog on a earlier strengths based approach to supporting families is hard to argue with. I could even see a ‘social investment’ argument that should be picked up by the CYF Review Panel.

Makes a lot of sense to me, as a s/w that has worked and continues to work with as many family members as possible at one time. This avoids multiple conflicting stories and untruths can be exposed early and addressed.
To work with the vunerable child in isolation from their family doesn’t make sense to me at all(of course there are a very few extreme cases where this may be necessary, but the focus needs to be getting the family members together to be working through the systemic /relationship breakdown asap.
If this work can happen at a early stage with the families, then we as a nation will likely see costs savings, as we will hopefully have less broken families, less children in care and less people in jail as a result. Lets not wait until the system is broken to the point where children are being removed-lets do good family focused work early!